Concussion (sport-related concussion)

What it is

A concussion is a brain injury caused by force transmitted to the head, either directly or through the body. The brain is shaken inside the skull and brain cells stop handling energy normally for a period of days to weeks. Nothing shows up on a standard scan, which is why concussions get waved off as nothing. There is no mild version you can play through, and the diagnosis is the same whether you were knocked out or just felt strange for ten minutes.

How volleyball causes it

Three patterns account for almost every volleyball concussion. A hard-driven ball hits the head at close range: a blocker taking a swing in the face from two metres away, a defender inside the ten foot line, or a passer catching a jump serve flush. Two players chase the same dig and collide in the seam, usually head to shoulder or head to head, and the head takes the whip. Third, the head reaches the floor, in a dive or a pancake that runs out of arm, or a bad landing off a block that puts the back of the head down, and on beach or grass a head-first landing into ground that is harder than it looks.

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What it feels like

• Headache or a feeling of pressure in the head, either straight away or building over the next day or two.
• Feeling foggy, slowed down or just not right, losing track of the rotation or the play call.
• Dizziness, feeling off balance, or the gym suddenly seeming too bright or too loud.
• Nausea, blurred or double vision, losing the ball in flight, reacting to the hitter late.
• Being unusually irritable, tearful or flat, and sleeping badly or far more than usual in the days after.
• Symptoms that get worse with reading, screens, or anything that raises your heart rate.

Stop and get it seen if

• Knocked out at all, even for a second, a seizure or convulsion, or a stretch of time you cannot remember. Emergency care.
• Headache that keeps getting worse, repeated vomiting, growing confusion or agitation, or becoming hard to rouse. Call emergency services.
• Neck pain or tenderness right on the bones of the neck alongside the head injury, or numbness, tingling or weakness in the arms or legs. Treat it as a possible spinal injury, do not move the player, call emergency services.
• Unequal pupils, slurred speech, double vision that does not clear, or weakness down one side of the body.
• Clear fluid or blood from the nose or ear, or bruising appearing behind the ear or around both eyes after a hard impact. Possible skull fracture.

What recovery usually looks like

Stages, not a schedule. Everyone moves through these at their own pace, and the ranges are wide because real recoveries are.

1. 1. Off the court, first day or two

   the first 24 to 48 hours

   Get the injury recognised and assessed and let the sharpest symptoms settle. The player is done for the day the moment a concussion is suspected. There is no version of this where they finish the set.

   • The player is out for the day even if they feel fine, because symptoms commonly arrive hours later.
   • Someone is with them for the first night and knows the red flags above.
   • Screens, loud gyms and heavy mental work are cut back, but total dark-room rest is not the aim and tends to slow recovery.
   • Seen by a doctor or other clinician who manages concussion, ideally within the first day.

2. 2. Light activity that does not stir symptoms

   roughly day 2 to the end of week one, sometimes longer

   Ordinary daily life plus easy movement such as walking or a stationary bike at an effort that barely nudges symptoms, and a staged return to school or work. Getting light aerobic work going early tends to shorten recovery rather than drag it out.

   • Easy exercise can be done without a clear spike in headache or fog.
   • Most of a normal school or work day is manageable, with screens tolerated.

Ready to play again when

• Symptom free at rest and through full-effort conditioning, with nothing appearing in the hours afterwards.
• Back to a full school or work load, including screens, without symptoms.
• Completed the whole stepwise progression, including full-speed non-contact volleyball and then full practice, without symptoms at any stage.
• Cleared by a clinician who manages concussion, before the first match rather than after it.
• Sleep, mood and concentration back at your own baseline, and ball tracking normal rather than half a beat late.

Keeping it from coming back

This is ordinary training, so unlike the rest of this page it does tell you what to do.

• Isometric neck holds in four directions, resisting your own hand or a wall at the forehead, back of the head and each side, held steady and built up over weeks. A stronger, stiffer neck means the head accelerates less when a ball or a teammate's shoulder hits it, and most volleyball players never train the neck at all.
• Chin tuck holds lying on your back, head just off the floor with the chin drawn in. These deep neck flexors control the whip of the head and they also protect the neck itself, which is frequently injured in the same moment as the brain.
• Blocking technique work with a coach hitting controlled balls at the block: press over with the eyes open and hands wide rather than turning the head away. Face contacts at the net come from flinching and closing the eyes at the last instant.
• Rehearse loud, early calls on short balls, free balls and anything landing in the seam between a defender and a chasing setter. Head-to-head collisions in volleyball nearly always happen where two players both went and neither called it.
• Peripheral awareness drills from defensive posture, such as a partner calling numbers or dropping a ball while you read the hitter's arm. Most head contacts come from a ball or a body you did not see coming.
• Clear the environment before you play: pad or move the referee stand, keep ball carts and benches back off the court, and on beach or grass walk the area for buried hard objects. A head that hits a cart is a worse injury than a head that hits a floor.